Individual
BRUCE A BECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N.P.
Contact information
Practice address
550 UNIVERSITY BLVD, INDIANAPOLIS, IN 46202-5149
(317) 944-8660
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71000570A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71000570A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200809460
—
IN
Enumeration date
08/23/2006
Last updated
01/26/2021
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